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NHS England to roll out Boots sore throat scheme

A sore throat ‘test and treat’ service first piloted by Boots in 2014 has been adopted onto an NHS England programme to be rolled out across the country.

The scheme, designed to prevent antibiotic resistance and reduce GP workload, will see community pharmacists conduct on-the-spot throat swab tests to determine whether patients need antibiotic treatment.

A pilot of the scheme ran across 20 Boots stores in London between October 2014 and April 2015, and another 15 branches in Leicestershire between January 2015 and April 2015.

A review of the pilot conducted by University College of London Hospitals and published in the Journal of Antimicrobial Chemotherapy in July, revealed that two-thirds of patients who would have seen their GP for their sore throat did not need to do so.

Boots estimates that an additional 800,000 patients could potentially be seen in community pharmacy rather than general practice if the service is rolled out nationwide, saving the NHS “millions”, it said last Saturday (November 12).

However, the review's authors admitted their calculations of savings did “not take into account the cost of delivery of the service within community pharmacies”.

Under the pilot, pharmacists trained to recognise bacterial infection in adults offered patients a swab test if they were displaying symptoms of a sore throat. Patients who tested positive for Streptococcus group A – typical bacteria associated with throat infections – were offered antibiotics.

Patients paid £7.50 for the test and a further £10 if antibiotics were supplied, with fees “calculated based on the cost of materials and staff resource to deliver the service”, Boots said when the pilot review was published.

Cost of delivery not known

C+D has asked Boots and NHS England to clarify whether these costs will remain when the scheme is rolled-out more widely, but is yet to receive a response.

It is also unclear if community pharmacies will be paid to deliver the service and whether they will receive similar monetary incentives for reducing antibiotic prescribing as GPs currently do.

Malcolm Harrison, senior manager project and contract development at Boots, and now fellow of the NHS England programme said: “I hope that the appointment brings more opportunity to work collaboratively with industry partners and other pharmacies."

Mr Harrison added that the scheme could provide "large-scale coverage" and "make sure that patients have a new access point of care to relieve burden on GPs, while also making sure that antibiotics are only given when needed.”

NHS Innovation Accelerator

The sore throat scheme is one of eight schemes selected for this year's NHS Innovation Accelerator (NIA) programme, which is designed to fast-track new treatments and technologies into the health service.

Announcing the new schemes last week (November 9), NHS England said that last year 17 “innovations” were rolled-out across "over" 380 NHS organisations – including smartphone app OWise, which allows patients to record in real time their experience of cancer therapies.

The projects selected to join this year’s programme were focused on three challenges: prevention, early intervention and long-term condition management, NHS England said.

The NIA is led by NHS England and delivered in partnership with 15 academic health science networks, 11 of which provide "financial contributions", including bursaries for fellows and to support the costs of programmes, NHS England said.

RPS welcomes service

Chair of the Royal Pharmaceutical Society's English pharmacy board Sandra Gidley described the news as a “win-win all round”.

“I’m delighted NHS England have fast-tracked this use of point-of-care diagnostics. It’s exactly the kind of direct patient care the RPS wants to see community pharmacists providing across the country as a matter of course.

"New technologies like this have the potential to enable patients to get quicker, accurate tests whilst still having that all-important conversation with a health professional to give appropriate advice and treatment," she added.

“Ideally we would like to see a national minor ailments service that encompasses this kind of treatment."

Listen to C+D's podcast with Professor Brendan Gilmore to find out if an antibiotic "apocalypse" is on the way

What do you think about the sore throat scheme?

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